Your blood test and the need for better designed results

Either as a patient or as a physician there’s a very high chance that you’ve ever got your hands on a simple blood test.

These range from very basic ones to complex ones with multiple pages and are substantial to any cinlical evaluation. Blood tests are probably one of the most performed tests in a clinical environment with direct patient contact. Also, if you’ve ever seen a typical blood test from the hospital’s laboratory then you’ll notice that they more look like a movie script than an informative medical report. Since the computer arrived in nowadays healthcare the form and design of these reports hardly changed.

Popular tech magazine Wired recently opened up a call for redesigning blood tests. Thinking about the design of ordinary blood tests, might just be one small step for patients but a giant leap for healthcare. They’ve called for new visualizations of common blood test forms and the amazingly skilled people at Information is beautiful won the first prize for Wired’s competition.

The goal was to re-design the report of a simple blood test that evaluated CRP and cholesterol levels. Here’s how the original test result looked like:

And here is how the re-design looks like:

Imagine the possible impact of such a report on patients. It would clearly help get the patient a much clearer picture of their condition and current physical state. The phyiscian’s reward would probably be more of an eye-candy that helps getting through long hospital days, rather than an actual increase in information. Unfortunately the chances of seeing such new approaches any time soon on a large scale remain low.

Lukas Zinnagl is a physician and co-founder of MedCrunch, an online magazine covering health, medicine, entrepreneurship and technology all centered around new trends and the challenge of being a physician.

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Your blood test and the need for better designed results 8 comments

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Finn

It’s beautiful, easy to read, and you can pick useful information from it at a glance, but it will never happen because no one’s wasting the money it would cost for 4-color printing of lab results. The same design in greyscale would have somewhat less visual impact but still be a vast improvement over the “secret missives from the CIA circa 1965” version.

Sadly, even the CIA missive is easier to read than the printouts I get from MGH and Tufts Medical Center, which look like lines of computer code spit out by a daisy-wheel printer in a monospaced font.

This form IS quite beautiful. Let’s hope it catches on. But the expense of 4-colour printing is a valid concern. Perhaps the ‘Wired’ geniuses can take that into consideration and make minor modifications to address that?

gme

Why couldnt it be in color on the computer screen and emailed securely to the patient, and then just print out in gray-scale?

We do something similar for our patients using McKesson’s secure patient portal Webview, although not in color or quite as pretty. We have prewritten templates so that with very little effort we can send a patient all their numeric lab results electronically with specific advice and education based on the numeric value. It is a highly effective intervention, provides rapid feedback to the patient and an opportunity to ask questions of the health care provider if clarification is needed.

Reta Russell Houghton

One problem I see is this only deals with a very small number (3) of test results. My primary runs a Chem 20, A Liver panel, lipid panel and sometimes a few others for our appointments. My report would be10 pages or longer.

I will say it is a very pretty report but even the lipid panel does not list Triglycerides, VDLD, and TC/HDL ratio. This multi-color explanation works well for a lipid panel. I don’t think all labs results would work with this type of format.

What I would like to see is more of a spreadsheet with past values listed. My doctor will be able to see any changes or any developing patterns. I have taken my labs and put them into a spread sheet in Excel. Results to the left and desired ranges to the right. When the ranges change, I start a new line. I think this helps my doctor determine if it is me or a change in testing ranges.

Reta Russell Houghton

I recommend going to Wired website to read the full article. They showed a variety of test results which are all very pretty but not completely functional. On the basic workup, they highlight the out of norm numbers and report the other as within normal ranges, not a number.

The WIRED magazine competition was focused on empowering patients with accurate, integrated and easily understood information about individual test results in the context of their personal health status, diagnoses and treatment. In the emerging era of personalized (participatory) medicine (http://participatorymedicine.org), this enhanced readability and usability could help patients and their physicians collaborate in maximizing quality and patient safety and minimizing duplicate, redundant and non-contributory testing.

What WIRED should consider doing next is sponsoring a competition to improve the flawed formats that are used to report the cumulative results of all 6,500 different diagnostic tests to the physicians who order them.

Unfortunately, the readability and usability of the formats used to report the billions of annual diagnostic test results in doctor offices and hospitals are severely limited by an antiquated user interface originally designed in the mainframe computing era.

The basic data management problem is that all ambulatory and hospital EHRs, and more recently PHRs and HIE platforms, still use infinitely variable formats to report cumulative test results as incomplete, fragmented data that is hard to read. Despite this flawed design’s serious adverse effects on physician workflow, costs, care quality and patient safety, in the “functional-but-frozen” U.S. markets for healthcare IT products, it has been almost completely overlooked.

The logical solution is to use a content exchange standard format to display all results as clinically integrated, complete information that is easy to read, analyze and act upon. Significantly improving test results reporting by making such a standard format available would facilitate the viewing and sharing of this vital information by physicians and patients, help physicians minimize testing costs, reduce medical errors, increase patient safety and improve collaboration and continuity of care.

If WIRED should someday sponsor a cumulative test results reporting makeover competition, the entry of a group of Rhode Island physicians is already posted at:

I applaud Wired’s and Diagnostic Information System’s recognition of the importance of human factored reporting. The medical community should be taking on such work. What has for decades been well known to industries with great public responsibility, such as nuclear power and airlines, is that human factoring is tantamount to safe operations. The medical community needs to be working to catch up as fast as it can.